The proposed study is an epidemiological cohort design that addresses two priority areas of the National Occupational Research Agenda, i.e. "Fertility and Pregnancy Abnormalities" and "Surveillance Research Methodology." The National Bureau of Labor Statistics 1996 report states that falls account for approximately 21 percent of all non-fatal injuries in the workplace, and 81.1 percent occur to workers in their reproductive years between ages 16 and 44. There are no statistics regarding the prevalence of workplace falls and injuries related to the pregnant worker even though there are 56.6 million female employees, comprising 43.2 percent of the civilian workforce, and 70.3 percent of women 20 years of age and older are employed during their pregnancy. Furthermore, pilot data from our laboratory suggests that one in five women will fall during pregnancy. Due to anatomical and physiological changes occurring during gestation, the pregnant worker is at high risk for falls and injury. At present, there are no surveillance methods in place to monitor falls and injuries of pregnant workers, and there are no studies and few guidelines on pregnant workers. The purpose of this study is to determine the prevalence rates of falls and fall related injuries and to identify the occupational and non-occupational risk factors leading to falls and fall related injuries at the workplace compared to elsewhere. The three hypotheses are that: 1) the risk factors associated with falls and injuries will be significantly different than those occurring elsewhere, 2) the rate of falls and injuries among those in health service and trade will be significantly higher compared to all other occupational groups, and 3) the rate and severity of injuries will be significantly higher in the workplace compared to elsewhere. This study proposes to survey 3627 women using a birth certificate database record system. Women will be identified within 4 to 6 weeks after delivery and their pregnancy work history, occupational and non-occupational risk factors and pregnancy history related to falls and injuries will be collected. A total design system using both telephone and mailed questionnaires to contact participants is proposed. A partnership with local public health officials has been implemented to build upon their current county-wide injury surveillance program. This proposed study provides a model program for surveillance of this vulnerable and high risk population of pregnant workers.